Posts Tagged ‘high deductible plans’

As a person of the liberal persuasion, I never needed much convincing that health care reform was a good idea. As someone who is single and self-employed, it’s been an even easier sell, especially as I’ve seen my individual premiums go up significantly during the past several years, to the point where I am currently paying $622.80 a month for a high deductible plan that doesn’t seem to cover much of anything.

I know that’s the point of high deductible plans, that they have…well…high deductibles. But I never got much benefit of the trade-off, which is supposed to be lower premiums. That’s because as a self-employed person on the individual market with a pre-existing condition, I had only option when it came to health insurance. That was to convert my post-divorce COBRA insurance into an individual policy, which I did a little more than two years ago, after my three years of COBRA expired.

So I wasn’t particularly upset when I received a notice from Highmark Blue Cross/Blue Shield a couple of months ago that my insurance policy was going to be cancelled. I was hopeful that I could find something better for at least the same price, if not less, through the Health Insurance Marketplace created by health care reform. As a resident of Pennsylvania, which does not have its own exchange, I was going to go into the federal exchange.

So, shortly after Oct. 1, I went to healthcare.gov and like so many others, couldn’t create an account. I was able to look at some policies and was encouraged to see that my costs were likely to fall. Like so many, I followed the saga in the news about the snafus with the site, which have been significant. Because of those issues, I didn’t try again until this week to access the site and create an account.

Over the course of several hours over several days, I was able to create an account and compare plans. I ultimately chose a gold plan that reduces my costs by $187.95 per month and gives me better benefits than what I had before, including:

Co-pays for doctor’s visits and prescriptions, which I have to pay for out of pocket now until my deductible is met

Co-pays for tests and emergency room visits, which I also now have to meet my deductible before getting any coverage

Lower out of pocket maximum

Although my overall deductible is higher — $1,500 vs $1,000, the co-pays really mitigate that because I am a healthy person who typically doesn’t consume a lot of care. I’m also getting dental coverage, which I haven’t had since my divorce; to be fair, I haven’t looked into it, but one major benefit of healthcare.gov is that it is easy to find, compare and buy insurance.

My experience may not be typical. I make too much money to qualify for subsidies, which simplifies the process. But, as one of the millions of Americans for whom health care reform was set up, I’d have to say it’s a success. From my POV, it’s been worth the few hassles and although the site shouldn’t have been so buggy in the first place, it’s working as advertised for me and thousands of others.

I really disagree first of all with those who believe healthcare reform wasn’t necessary and secondly, with those who believe the bungled set up of the site completely undercuts not only healthcare reform but the Obama administration. Nonsense — of course, it should have been handled better. But it’s working and the fixes will continue to help it function more smoothly and over the next months and years it will fulfill its promise, which is to extend health care choice to millions of Americans. Count me in.